Skip to main content
SpringerLink
Log in

Pterygium

  • Chapter
Radiotherapy for Non-Malignant Disorders

Part of the book series: Medical Radiology ((Med Radiol Radiat Oncol))

Abstract

A pterygium is a wing-shaped (in Greek, pteron means wing) or triangular structure of benign proliferation of the fibrovascular tissue originating from the bulbar conjunctiva, which grows invasively over months or years toward the center of the cornea, using the Bowman’s layer as a guiding structure and resulting in its destruction [10, 46]. Pterygia are nearly exclusively located nasally (92%), and simultaneous bilateral growth may be found in 4%–5%. Sequential bilateral ocular involvement may occur in up to one-third of patients with pterygia.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 189.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 249.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 329.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Similar content being viewed by others

References

  1. Alaniz-Camino F (1982) The use of postoperative beta radiation in the treatment of pterygia. Ophthalmic Surg 13:1022–1025

    PubMed  CAS  Google Scholar 

  2. Aswad MI (1987) Optimal time for postoperative irradiation of pterygia. Ophthalmol 94:1450–1451

    CAS  Google Scholar 

  3. Austin P, Jakobiec FA, Iwamoto T (1983) Elastodysplasia and elastodystrophy as the pathologic bases of ocular pterygia and pinguecula. Ophthalmol 90:96–109

    CAS  Google Scholar 

  4. Bahrassa F, Datta R (1983) Postoperative beta radiation treatment ofpterygium. Int J Radiat Oncol Biol Phys 9:679–684

    PubMed  CAS  Google Scholar 

  5. Beyer DC (1991) Pterygia: Single-fraction postoperative beta irradiation. Radiology 178:569–571

    PubMed  CAS  Google Scholar 

  6. Brenner DJ, Merriam GR (1994) Postoperative irradiation for pterygium: Guidelines for optimal treatment. Int J Radiat Oncol Biol Phys 30:721–725

    PubMed  CAS  Google Scholar 

  7. Burk A (1912) Die Behandlung der Homhautepitheliome durch Röntgenstrahlen. Strahlenther Onkol 1:168–171

    Google Scholar 

  8. Cameron M (1965) Pterygium throughout the world. Thomas, Springfield IL

    Google Scholar 

  9. Cameron M (1972) Preventable complications of pterygium excision with beta-irradiation. Br J Ophthalmol 56:52–56

    Article  PubMed  CAS  Google Scholar 

  10. Cameron ME (1983) Histology of pterygium: an electron microscopic study. Br J Opthmalmol 67:604–608

    Article  CAS  Google Scholar 

  11. Campbell OR, Amendola BE, Brady LW (1990) Recurrent pterygia: Results of postoperative treatment with Sr-90 applicators. Radiology 174:565–566

    PubMed  CAS  Google Scholar 

  12. Chen PP, Ariaysu RG, Kaza V, LaBree LD, McDonnell PJ (1995) A randomized trial comparing mitomycin C and conjunctival autograf after excision of primary pterygium. Am J Ophthalmol 151:151–160

    Google Scholar 

  13. Cooper JS (1978) Postoperative irradiation of pterygia: 10 more years of experience. Radiology 128:753–756

    PubMed  CAS  Google Scholar 

  14. Coroneo MT (1993) Pterygium as an early indicator of ultraviolet insolation: a hypothesis. Br J Ophthalmol 77:734–739

    Article  PubMed  CAS  Google Scholar 

  15. DeKeizer R (1982) Pterygium excision with or without postoperative irradiation, a double-blind study. Doc Ophthal 52:309–315

    Article  CAS  Google Scholar 

  16. Dorr RT (1988) New findings in the phamacokinetic, metabolic, and drug-resistance aspects of mitomycin C. Semin Oncol 15:32–41

    PubMed  CAS  Google Scholar 

  17. Duke-Eider S (1965) Diseases of the outer eye. System of Ophthalmology, conjunctiva, vol 8. Kimpton, London, pp 570–573

    Google Scholar 

  18. Dusenbery KE, Alul IH, Holland EJ, Khan FM, Levitt SH (1992) Irradiation of recurrent pterygia: results and complications. Int J Radiat Oncol Biol Phys 24:315–320

    PubMed  CAS  Google Scholar 

  19. Dushku N, Tyler N, Reid TW (1993) Immunohistochemical evidence that pterygia arise from altered limbal epithelial basal stem cells. Invest Ophthalmol Vis Sci 34:1013–1018

    Google Scholar 

  20. Friedeil HL, Thomas CI, Knohmer JS (1950) Beta ray applications to the eye. Amer J Ophthalmol 33:525–533

    Google Scholar 

  21. Frucht-Pery J, Siganos CS, Ilsar M (1996) Intraoperative application of topical mitomycin C for pterygium surgery. Ophthalmol 103:674–677

    CAS  Google Scholar 

  22. Grimmett MR, Holland EJ (1997) Management of pterygium. Cornea, surgery of the cornea and conjunctiva, vol III. Mosby, St Louis, pp 1873–1885

    Google Scholar 

  23. Hara T, Shoji E, Hara T, Obara Y (1994) Pterygium surgery using the principle of contact inhibition and a limbal transplantated pedicle conjunctival strip. Ophthalmic Surg 25:95–98

    PubMed  CAS  Google Scholar 

  24. Harris AL (1997) Antiangiogenesis for cancer therapy. Lancet 349:13–15

    Article  CAS  Google Scholar 

  25. Hayasaka S, Noda S, Yamamoto Y, Setogawa T (1988) Postoperative instillation of low-dose mitomycin C in the treatment of primary pterygia. Am J Ophthalmol 106:715–718

    Article  PubMed  CAS  Google Scholar 

  26. Hill JC, Maske R (1989) Pathogenesis of pterygium. Eye 3:218–226

    PubMed  Google Scholar 

  27. Ioachim-Velogianni E, Tsironi E, Agnantis N, Datseris G, Psilas K (1995) HLA-DR antigen expression in pterygium epithelial cells and lymphocyte subpopulations: an immunohistochemistry study. Germ J Opththal 4:123–129

    CAS  Google Scholar 

  28. Jaros PA, DeLuise VP (1988) Pingueculae and pterygia. Surv Ophthalmol 32:41–49

    Article  Google Scholar 

  29. Jürgenliemk-Schulz IM, Hartman LJC, Roesink JM et al (2004) Prevention of pterygium recurrence by postoperative single-dose beta-irradiation: a prospective randomized clinical double-blind trial. Int J Radiat Oncol Biol Phys 59:1138–1147

    Article  PubMed  Google Scholar 

  30. Kenyon KR, Wagoner MD, Hettinger ME (1985) Conjunctival autograft transplantation for advanced and recurrent pterygium. Opthalmol 92:1461–1470

    CAS  Google Scholar 

  31. Kria L, Ohira A, Amemiya T (1996) Immunohistochemical localization of basic fibroblast growth factor, platelet derived growth factor, transforming growth factor-ß and tumor necrosis factor-α in the pterygium. Acta Histochem 98:195–201

    PubMed  CAS  Google Scholar 

  32. Kunitomo N, Mori S (1963) Studies on the pterygium. Part 4. A treatment of the pterygium by mitomycin-C instillation. Acta Soc Ophthalmol Jpn 67:601–607

    Google Scholar 

  33. Kwok LS, Coroneo MT (1994) A model for pterygium formation. Cornea 13:219–224

    Article  PubMed  CAS  Google Scholar 

  34. Lentino W (1979) Treatment of pterygium by surgery followed by beta radiation. Am J Roent Rad Ther + Nuc Med 81:93–98

    Google Scholar 

  35. Lommatzsch PK (1993) Conjunctival tumors and their radiotherapy. Alberti WE, Sagerman RH (eds) Radiotherapy of intravascular and orbital tumors. Springer, Berlin Heidelberg New York, pp 227–237

    Google Scholar 

  36. Luster AD (1998) Chemokines-chemotactic cytokines that mediate inflammation. N Engl J Med 338:436–445

    Article  PubMed  CAS  Google Scholar 

  37. MacKenzie FD, Hirst LW, Kynaston B, Bain C (1991) Recurrence rate and complications after beta irradiation for pterygia. Ophthalmol 98:1776–1781

    CAS  Google Scholar 

  38. MacKenzie FD, Hirst LW, Battistutta D, Green A (1992) Risk analysis in the development of pterygia. Ophthalmol 99:1056–1061

    CAS  Google Scholar 

  39. Mahar PS, Nwokora GE (1993) Role of mitomycin C in pterygium surgery. Br J Ophthalmol 77:433–435

    Article  PubMed  CAS  Google Scholar 

  40. Mastropasqua L, Carpineto P, Ciancaglini M et al (1994) Effectiveness of intraoperative mitomycin C in the treatment of recurrent pterygium. Ophthalmol 208:247–249

    CAS  Google Scholar 

  41. Moller DE, Goder GJ (1992) Lokale Mitomycin-C-Therapie nach Pterygiumexzision. Klein Monatsbl Augenheilkd 200:213–232

    Article  Google Scholar 

  42. Monselise M, Schwartz M, Politi F, Barishak YR (1984) Pterygium and beta irradiation. Acta Ophthalmol 62:315–319

    CAS  Google Scholar 

  43. Moran DJ, Hollows FC (1984) Pterygium and ultraviolet radiation: a positive correlation. Br J Ophthalmol 68:343–346

    Article  PubMed  CAS  Google Scholar 

  44. Moriarty AP, Crawford GJ, McAllister DL, Constable U (1993) Severe corneoscleral infection. A complication of beta irradiation scierai necrosis following pterygium excision. Arch Ophthalmol 111:947–951

    PubMed  CAS  Google Scholar 

  45. Nakamura K, Bissen-Miyajima H, Shimmura S, Tsubota K (2000) Clinical application of ER:YAG laser for treatment of pterygium. Ophthalmic Surg Lasers 31:8–12

    PubMed  CAS  Google Scholar 

  46. Naumann GOH (1997): Pathologie des Auges von Naumann, Hrsg von Doerr und Seifert. Springer, Bd 12/I, 2. Auflage, pp 443–445

    Google Scholar 

  47. Neal AJ, Irwin C, Hope-Stone HF (1991) The role of strontium-90 beta irradiation in the management of pterygium. Clin Oncol 3:105–109

    Article  CAS  Google Scholar 

  48. Nowell JF (1986) Management of pterygia 20 years later. South Med J 79:1382–1384

    Article  PubMed  CAS  Google Scholar 

  49. Pajic B, Pugnale-Verillotte N, Greiner RH, Pajic D, Eggspühler A (2002) Résultat de la thérapie au strontium-yttrium-90 des ptérygions. J Fr Ophthalmol 25:473–4799

    CAS  Google Scholar 

  50. Pajic B, Pallas A, Aebersold D, Greiner RH (2004) Prospektive study about course of primary pterygia after exclusive treatment with Sr-/Y-90 irradiation Strahlenther Oncol (in press)

    Google Scholar 

  51. Paryani SB, Scott WP, Wells JW, Johnson DW, Chobe R, Kuruvilla A, Schoeppel S, Deshmukh A, North Florida Pterygium Study Group (1993) Management of pterygium with surgery and radiation therapy. Int J Radiat Oncol Biol Phys 28:101–103

    Google Scholar 

  52. Pepper MS (1996) Positive and negative regulation of angiogenesis: from cell biology to the clinic. Vascul Med 1:259–266

    CAS  Google Scholar 

  53. Pinkerton ÖD, Hokama Y, Shigemura LA (1984) Immunologic basis for the pathogenesis of pterygium. Am J Ophthalmol 98:225–228

    PubMed  CAS  Google Scholar 

  54. Rachmiel R, Leiba H, Levartovsky S (1995) Results of treatment with topical mitomycin C 0.02 following excision of primary pterygium. Br J Ophthalmol 79:233–236

    Article  PubMed  CAS  Google Scholar 

  55. Ratnakar KS, Goswany V, Agarwal LP (1976) Mast cells and pterygium. Acta Ophthalmol 54:363–368

    Article  CAS  Google Scholar 

  56. Rojas JR, Malaga H (1986) Pterygium in Lima, Peru. Ami Ophthalmol 18:147–149

    CAS  Google Scholar 

  57. Rosenthal G, Shoham A, Liftshitz T, Biedner B, Yassur Y (1993) The use of mitomycin in pterygium surgery. Ann Ophthalmol 25:427–428

    PubMed  CAS  Google Scholar 

  58. Rubinfeld RS, Pfister RR, Stein RM, Foster CS, Martin NF, Stoleru S, Talley AR, Speaker MG (1992) Serious complications of topical mitomycin-C after pterygium surgery. Ophthalmol 99:1647–1654

    CAS  Google Scholar 

  59. Rubinfeld RS (1993) Mitomycin-C after pterygium excision. Ophthalmol 100:977–981

    Google Scholar 

  60. Schultze J, Hmrichs M, Kimmig B (1996) Ergebnisse der Strontium-90-Kontakttherapie zur Rezidivprophylaxe des Pterygiums. Strahlenther Onkol 172:417–421

    PubMed  CAS  Google Scholar 

  61. Seiler T, Schnelle B, Wollensak J (1992) Pterygium excision using 193-nm excimer laser smoothing and topical mitocycin C. Ger J Ophthalmol 1:429–431

    PubMed  CAS  Google Scholar 

  62. Singh G, Wilson R, Foster CS (1988) Mitomycin eye drops as treatment for pterygium. Ophthalmol 95:813–820

    CAS  Google Scholar 

  63. Singh G (1989) Postoperative instillation of low-dose mitomycin C m the treatment of primary pterygium. Am J Ophthalmol 107:570–571

    PubMed  CAS  Google Scholar 

  64. Sugar A (1992) Who should receive mitomycin-C after pterygium surgery? Ophthalmol 99:1645–1646

    CAS  Google Scholar 

  65. Tarr KH, Constable U (1980) Late complications of pterygium treatment. Br J Ophthalmol 64:496–505

    Article  PubMed  CAS  Google Scholar 

  66. Tarr KH, Constable U (1981) Radiation damage after pterygium treatment. Aust J Ophthalmol 9:97–101

    Article  PubMed  CAS  Google Scholar 

  67. Taylor HR (1980) Aetiology of climatic droplet keratopathy and pterygium. Br J Ophthalmol 64:154–163

    Article  PubMed  CAS  Google Scholar 

  68. Tetsushi N, Ikuo W, Akira M, Shigekuni O, Nobuyuki E (2000) Expression of stem cell factor in pterygium. Jpn J Ophthalmol 44:193–197

    Article  Google Scholar 

  69. Ti SE, Chee SP, Dear KBG, Tan DTH (2000) Analysis of variation in success rates in conjunctival autografting for primary and recurrent pterygium. Br J Ophthalmol 84:385–389

    Article  PubMed  CAS  Google Scholar 

  70. Van den Brenk HA (1968) Results of prophylactic postoperative irradiation in 1300 cases of pterygium. Am J Roentgenol 103:723–733

    Google Scholar 

  71. Wilder RB, Buatti JM, Kittelson JM, Shimm DS, Harari PM, Rogoff EE, Cassady JR (1992) Pterygium treated with excision and postoperative beta irradiation. Int J Radiat Oncol BiolPhys 23:533–537

    Article  CAS  Google Scholar 

  72. Willner J, Flentje M, Lieb W (2001) Soft X-ray therapy of recurrent pterygium-an alternative to Sr-90 eye applicators. Strahlenther Oncol 177:404–409

    Article  CAS  Google Scholar 

  73. Wilson SE Bourne WM (1988) Conjunctival Z-plasty in the treatment of pterygium. Am J Opthalmol 106:355–35

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Departement Radiation Oncology, University Bern, Inselspital, Freiburgerstrasse 10, 3010, Bern, Switzerland

    Richard H. Greiner MD (Professor)

  2. Clinic Pallas, Eye Center, Louis Giroud-Strasse 20, 4600, Olten, Switzerland

    Bojan Pajic MD

  3. Department of Radiology, Med. School, Joh. Gutenberg University, Langenbeckstrasse 1, 55131, Mainz, Germany

    Joachim Kutzner MD (Professor)

  4. Rheumatologie, Charité — Universitätsmedizin Berlin, Hindenburgdamm 30, 12200, Berlin, Germany

    Joachim Kutzner MD (Professor)

Authors
  1. Richard H. Greiner MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Bojan Pajic MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Joachim Kutzner MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Department of Radiation Oncology and Therapeutic Radiology, Alfried-Krupp-Hospital, Alfried-Krupp-Strasse 21, Postfach 10 22 43, 45117, Essen, Germany

    Michael Heinrich Seegenschmiedt MD (Professor) (Professor)

  2. Strahlenklinik Klinikum Duisburg, Zu den Rehwiesen 9, 47055, Duisburg, Germany

    Hans-Bruno Makoski MD (Professor) (Professor)

  3. Department of Radiation Biology, St. Bartolomew’s Medical College, Charterhouse Square, London, EC1M 6BQ, UK

    Klaus-Rüdiger Trott MD (Professor) (Professor)

  4. Hylda Cohn/American Cancer Society, USA

    Luther W. Brady MD (Professor of Clinical Oncology, and Professor, Department of Radiation Oncology Distinguished University Professor) (Professor of Clinical Oncology, and Professor, Department of Radiation Oncology Distinguished University Professor)

  5. College of Medicine, Drexel University, Broad & Vine Sts., Mail Stop 200, Philadelphia, PA, 19102-1192, USA

    Luther W. Brady MD (Professor of Clinical Oncology, and Professor, Department of Radiation Oncology Distinguished University Professor) (Professor of Clinical Oncology, and Professor, Department of Radiation Oncology Distinguished University Professor)

Rights and permissions

Reprints and permissions

Copyright information

© 2008 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Greiner, R.H., Pajic, B., Kutzner, J. (2008). Pterygium. In: Seegenschmiedt, M.H., Makoski, HB., Trott, KR., Brady, L.W. (eds) Radiotherapy for Non-Malignant Disorders. Medical Radiology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-68943-0_28

Download citation

  • DOI: https://doi.org/10.1007/978-3-540-68943-0_28

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-62550-6

  • Online ISBN: 978-3-540-68943-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation